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A Prospective Randomized Comparison of Two Different Pelvic Pouch Designs

1990; Taylor & Francis; Volume: 25; Issue: 10 Linguagem: Inglês

10.3109/00365529008997624

1502-7708

Tom Øresland, S. Fasth, S. Nordgren, Thomas Hallgren, L. Hultén,

Hernia repair and management

AbstractThe clinical, manovolumetric, and functional results of restorative proctocolectomy were studied in patients randomly allocated to construction of either a J-shaped pouch (n = 29) or a pouch fashioned by the folding technique used for the Kock continent ileostomy (K-pouch) (n = 26). A complete endoanal mucosectomy was performed, and the pouches were all constructed from 30-cm lengths of ileum. There were no deaths and no significant difference in postoperative morbidity. Anal pressures were equal in the two groups. The K-pouch expanded more favourably postoperatively, and its volume at 1 year was significantly greater than that of the J-pouch (355 ± 71 ml (SD); range, 225–95, versus 264 ± 81 ml; range, 75–440; p < 0.001). The pouches had similar motility patterns and sensory pressure thresholds. Initially after closure of the loop ileostomy there was a tendency for better functional outcome in K-pouch patients. At 1 year the overall distribution of functional defects did not differ, and the defaecation frequency was about equal in the groups.Key Words: Manovolumetrypelvic ileal pouchulcerative colitis